Kiran Kenth, Wider Workforce Development Manager at RSPH, explains why services such as the West Midlands Fire Service have the potential to impact on virtually every important issue affecting health and wellbeing.

Could the West Midlands Fire Service be the next major public health workforce? I definitely think so! They are on a mission to improve lives to save lives through: Prevention, Protection and Response.

I was asked to represent RSPH at the West Midlands Fire Service Health Inequalities Conference on 18th November 2014 and what an inspirational and motivating experience this was. I was honoured to be in the company of Professor Sir Michael Marmot, the Chief Fire Officer for West Midlands Fire Service, Phil Loach and Director of Service Delivery, Gary Taylor. I was truly inspired by the high level of organisational leadership, commitment and positive energy to engage with improving the public’s health and wellbeing agenda, as well as the sheer dedication to contribute to the reduction of health inequalities through organisational adoption of the Marmot  objectives.

The West Midlands Fire Service is a large, relatively untapped public health resource with potential to impact on virtually every important issue affecting health and wellbeing. They have a key role in terms of “prevention” and risk reduction strategy, targeted at vulnerable communities shown to be at highest risk of deprivation and ill health.

What I learned was invaluable. The devotion and diligence of the West Midlands Fire Service  as much as their  commitment and persistence in tackling “the root causes was truly inspiring.  The Chief Fire Officer, Phil Loach launched the West Midlands Fire Service Report; “Marmot; The way forward” and spoke about the vision and the strategic priorities of the West Midlands Fire Service and how this is now centred on prevention and wellbeing.

WMFS have developed a major prevention and health improvement programme; “making health everybody’s business” and yet still remain fully committed to providing the highest standard of emergency incident cover, including the delivery of a risk based 5 minute attendance to incidents where life and property are at risk. Their mantra is “Prevention, Protection, Response” where prevention and protection remain their highest priority with emergency response being the first line of defence.

Phil Loach described his workforce as “a high performing, flexible workforce, able to cope with  innovation and change and who are encouraged to be the very best they can be and do whatever it takes in pursuit of excellence”.

I am sure that many people still have the traditional view of a fire service as the red fire brigade and putting out fires.  But I can honestly say, this is simply not the case anymore.  I was completely taken aback by the wide range of programmes that have been designed  by WMFS to tackle issues such as:

  • Dysfunctional neighbours
  • Anti social behaviour
  • Disability
  • Preventable ill health and early death
  • Empowering people to improve wellbeing in communities that traditionally suffer poor health outcomes
  • Engaging directly with households and neighbourhoods
  • Helping people of all ages, cultures and backgrounds to achieve sustainable behaviour change
  • Healthy neighbourhoods and improvements in community resilience
  • Improving life chances and equality of opportunity

There are 1322 FTE fire fighters across the West Midlands; 58 technical support officers; 61 fire safety officers and 38 fire stations in the region. This is equivalent to at least a million contacts with the public, across the West Midlands.  That is a significant number of opportunities to make an impact on public health and harness the untapped resource across a wider workforce.

The new West Midlands Fire Service delivery model that they describe as a “modern day fire and rescue service”, brings 21st century vision and a depth of understanding to health improvement and self-recognition of the contribution the fire service have to play in this agenda.  As I discovered, when I met with Gary Taylor, 10% of a fire fighters time is spent attending an emergency call out to a fire.  The rest of the time is committed to protection and prevention and by adopting  the prevention methodology, West Midlands Fire Service have seen a 40% reduction in fires across the midlands region. A very proud achievement.

Hearing some fire fighters talk about their own experiences and sharing case studies really enlightened me with regards to the capability, capacity and reach such a workforce has and the contribution they make to improving health and saving lives. The access and level of engagement Fire Officers have to vulnerable people is far greater and meaningful than what a health care professional or even a social worker might have. They engage and find the most vulnerable people with their proactive outreach approach and have demonstrated how they can improve the lives of people living with dementia, older people with physical impairments, troubled young people with youth offending history, as well as housed people living in poor housing conditions.

What became apparent were the wide ranging day to day responsibilities of the workforce, engaging those communities at highest risk.  Such examples include:

  • Proactive Engagement and outreach with the most vulnerable, such as people dealing with:  homelessness; NEETs;  mental health issues; troubled families; older people; domestic violence
  • Educational programmes working with children in schools and children's centres
  • Aurora Boot camps for young people looking for chances of employment, mentoring schemes designed to support young people in experiencing significant life difficulties
  • Young Fire Fighters Association
  • Alcohol & Drug awareness community sessions
  • Safe Haven residential schemes – outdoor activities
  • Interactive schemes alerting young people to the dangers of gun and knife crime
  • Using Vulnerable People Officers to work directly with groups such as the frail elderly
  • Supporting one on one home safety checks
  • Home visits by fire fighters trained in MECC and social determinants. Most of the fire fighters are using ‘making every contact count’ to have tailored conversations about improving health and wellbeing and supporting individuals to make lifestyle behaviour changes.  For example, using the home safety visit to have a conversation about issues such as stopping smoking, being more active, winter warmth, fuel poverty etc
  •  Links and partnership working with other agencies supporting multiagency case management to the most vulnerable and at risk communities
  • Key role in child and adult safeguarding

Many think the NHS, public health and social care system is unsustainable without radical transformation. The ageing population, increase in lifestyle-related poor health and financial forecasts mean it has never been more urgent to shift our focus to prevention. We need to take every opportunity to create the environment, information and support to help people and communities change their behaviour and to enjoy better health and wellbeing.

The West Midlands Fire Service have clearly demonstrated how they can contribute in a big way to this system-wide transformation. They are a workforce out in the public domain being active and vigilant and improving the conditions by which people live  and face on a day to day basis. By engaging at the level they do (i.e. climbing thorough windows to get to isolated people and not giving up on them)  they are not only providing the education and support to enable the public to make healthy informed choices but improving the quality of people’s lives.

So what needs to happen to make the most of the fire service’ potential to enhance public health delivery:

  • It is time to review the future role and funding allocation of the fire service and its highly regarded operational staff
  • We need to promote the Fire Service as a wider public health workforce and disseminate the good practice and innovation in prevention and contribution they make to the public’s health and wellbeing
  • Public health commissioners need to consider  whether the Fire service should be part of commissioning plans for the future
  • There is a need for more research to be published  on the evidence base of the potential impact of the fire service on public health

West Midlands Fire Service is an exemplary model of a wider workforce.  I commend them on their effort, successes and achievements to date. They are a workforce which needs to be recognised, acknowledge and celebrated by the public health system and I know that RSPH are privileged to have Chief Fire Officer on the Board. 

Exciting times ahead and RSPH look forward to continue building our relationship with West Midlands Fire Service.